New! Please Help - No regulation :(

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SilverSap

SilverSap

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Hi Everyone! I have been reading posts for the last few months and it has been very helpful as my 6 yr old cat was diagnosed with diabetes in May of this year. I am finally posting myself to see if anyone might be able to help give some support or advice as we have had no luck in regulating Blackberry. Blackberry was not overweight when diagnosed and is seemingly a "young" kitty. He showed no behavioral concerns except sudden weight loss which is why we brought him to the vet. Since the diagnosis, he has been on a wet food diet only (Wellness Complete Health Natural Wet Canned Cat Food). When first diagnosed, Blackberry was on Lantus. We started at 1u twice daily, that got bumped up to 2u twice daily, and in July/August we were working with 3u once daily in the morning. We were never able to get him on a regular pattern. We take his BG twice a day pre-shot and have done so since the very beginning. He gained weight back almost immediately which was wonderful!

As of earlier this month he has been switched to the ProZinc and we are having the same trouble of finding any sort of regularity in his readings. His SS is in my signature. We were able to do 2 curves last weekend which were both very random and unclear as you can see in his numbers. As of today, I spoke with the vet who would like us to increase his dosage by .5 when his BG reads above 200. Hoping that someone might be able to lend some support or suggestions!

Additional info: Blackberry is 1 of 3 kitties in the house. They are on a good schedule of twice daily feedings.
 

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Welcome! It sounds like you are doing the right things for Blackberry (great name btw) you have a mild, long lasting insulin, are testing at home and feeding wet food (do you know the carb level?)

He does seem to be bouncing all around. I think we can help. One, you need to get some more mid cycle numbers (5-7 hours the shot) to see how low a specific dose takes him. Two, shooting the same dose for a 183 and a 400, for example, is not working well. It may take him too low on the 183 causing him to bounce. And be an okay dose for the 400. (Bouncing is when his body perceives a number lower than it is used to, releases extra glucose and causes the level to "bounce" up higher, because of the extra sugar.). And ProZinc is different than Lantus. Shooting below 180 is not wise and may take him lower than safe. Your shots at 126/137 may have taken him very low - and caused a big bounce for later pre shots or later cycles.

If you can get some midcycle numbers for us, we can help with dosing. Have you see our protocol and Beginner's guide? They are in my signature in blue and may be helpful.
 
Hi and welcome with Blackberry:)
He's indeed bouncing a lot and I agree with Sue's advise on this one. Maybe you can try also to increase dosis with less big steps of 0.50. Try (if you are using U40 syringes) to eyeball a 0.25 increase instead of a bigger one. It can help you understand what Prozinc is doing to Blackberry's numbers.
And indeed, try get some midcycle numbers they give us so much info!
 
Sue and Oliver (GA) said:
Welcome! It sounds like you are doing the right things for Blackberry (great name btw) you have a mild, long lasting insulin, are testing at home and feeding wet food (do you know the carb level?)

He does seem to be bouncing all around. I think we can help. One, you need to get some more mid cycle numbers (5-7 hours the shot) to see how low a specific dose takes him. Two, shooting the same dose for a 183 and a 400, for example, is not working well. It may take him too low on the 183 causing him to bounce. And be an okay dose for the 400. (Bouncing is when his body perceives a number lower than it is used to, releases extra glucose and causes the level to "bounce" up higher, because of the extra sugar.). And ProZinc is different than Lantus. Shooting below 180 is not wise and may take him lower than safe. Your shots at 126/137 may have taken him very low - and caused a big bounce for later pre shots or later cycles.

If you can get some midcycle numbers for us, we can help with dosing. Have you see our protocol and Beginner's guide? They are in my signature in blue and may be helpful.
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Thank you so much for the reply! Those suggestions alone have already made me feel quite a bit better and more optimistic. I can certainly get more mid cycle readings this weekend and next week. Thank you for letting me know about the dosage concern regarding his readings... unfortunately we weren't given much education on the new insulin but that makes complete sense. What would you suggest in terms of dose if his readings are in the low 200s? Unfortunately, they have been relatively high the last few readings but are you suggesting less of a dose than the 3u for BG levels in the 200s?
 
I'd really like to see those midcycle numbers before I give much dosing advice (other than not to shoot below 180 or so). If he is dropping low mid cycle and bouncing back up, then you don't raise the dose and maybe lower it. If he is flat and doesn't drop, then you might keep it (if he is in nice ranges) or raise a little if he is in higher ranges. More data = better advice.

If you get a number near the 180/200 range, stall. Wait 20 minutes without feeding (food raises bg levels) and retest. You want to make sure the number is rising, not still falling and nearer your target. And maybe skinny up the dose a little from the cycle before.

In general, we consider a cat regulated if they are in the mid 200s at pre shot time and in the low 100s or double digits at nadir (5-7 hours after the shot) but not below 50 on a human meter or 68 on a pet meter - those levels are near hypo range.
 
I agreed we need to see the preshot numbers plus a bunch of mid cycle numbers to know how he's reacting. I suspect we will actually advise you to lower the dose a bit too see if it's bouncing we are seeing. Hard to know what's going on from preshot alone. This weekend take readings at preshot and then every two hours until post shot.
 
you shot 2 units when he was at 84.... That should have been a no shoot as its possible he went into dangerously low hypo numbers. The high number the next day was most likely a bounce from going to low the night before

I would reduce the dose for a few cycles and let him get back into a normal rhythm. It looks like he's sinking and bouncing. I'll leave the specific dosing suggestion to someone else with ProZinc experience, but that would be my guess.
 
Hi everyone! We lowered Blackberry's dose for the last few cycles to 1.5u and were able to get a number of midday readings. He had some very high readings but we wanted to give it a couple of cycles to see how he reacted. Please take a look and let me know your thoughts! As of this morning, we bumped him to 2u. My husband is home and can take some middday readings today as well.

I also have a question regarding feeding schedule. We feed him wet food in the morning pre shot and in the evening pre shot. We leave the food out for him and I notice that he will graze and eat throughout the day. What is the best way to feed diabetic cats? Do we remove the food after a certain time? Or is it okay for him to graze all day long?

Thanks again everyone!
 
Hi there - what we do is test - get the pre shot number - then feed them (some or all of their meal) and then give them the insulin
I leave Murphy food out all day, except I take up the food 2 hours before his pretests - they should not have food within 2 hours of their test as the food can elevate the number - make sense?
 
Yes, that is what we do. Take the BG reading, give food, then shot. But because we leave the food out for him most of the day so that he can continue to graze, I wasn't sure if some of the midday readings from this weekend may be effected by the food. I can certainly remove the food bowl 2 hours before the pretests though.
 
Glad you are testing before he eats. How much is he eating? Is he overweight or underweight? Some people swear by 2 meals a day and maybe a small snack at nadir; some let them graze.

I like your two units this am. Let's see how he looks tonight.
 
We split a 12oz can between our 3 cats in the morning and then again in the evening. So technically, he is given 4oz twice a day, sometimes the dish is empty by the next feeding, or sometimes there is a bit of food left. We do remove it prior to the next feeding if there is food left though so that it does not affect the BG pre shot reading. He is an 11lb cat, not overweight at all for his size. He is the smallest of the 3 cats in the house.

Updated his SS with some midday readings today. Will be taking his next reading before the shot in about 40 min. Thanks for your help!!
 
Sue and Oliver (GA) said:
Glad you are testing before he eats. How much is he eating? Is he overweight or underweight? Some people swear by 2 meals a day and maybe a small snack at nadir; some let them graze.

I like your two units this am. Let's see how he looks tonight.
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Blackberry had a high reading again last night, so we stuck with the 2u. This morning he was at 104! So we skipped the shot... I am not sure why he is so low! He has been consistently high the last few cycles ...
 
That is confusing. Nice to see a blue, but confusing. All I can suggest is to keep getting data and see what happens midcycle. (Wondering if his amps is the lowest number in the cycle? Or did he go low and the amps is on the way up? Wonder what his nighttime nadirs look like) I think you have to skip and then expect that pmps is likely to be high (not only a bounce but 12 hours without insulin). I think I would still reduce a little.

Is there any way to get a nadir overnight? Some people are of a certain age and get a number when they are up anyway; others set an alarm and quick get a test and go back to sleep.

I am wondering if his night cycles run consistently lower than his am cycles, meaning the am cycles could reflect a bounce daily....
 
We will get a few midday readings today for sure. I feel like he is not consistent at all as you can see the days before, his amps and pmps were both in the 400s or 500s with mid cycle readings in the 300s. And then this morning a huge drop. I will also try and get a reading or 2 after the pmps tonight to monitor if his night cycles are lower than the day cycles..
 
Hello! Having continued trouble with Blackberry and am just really not sure what to do.. can anyone take a look at his SS and offer any sort of advice? Thanks so much!
 
I'd increase the dose. You've had some strange numbers - like the 104, but generally he is high. I'd try 2.25 on the pinks and if you get a yellow, go with the two. You want to start seeing more yellows and blues, so slow steady increases every couple of days should get you there.
 
Hey, wondering if anyone might be able to look at Blackberry' spreadsheet.. We've been dosing regularly as 2.25 or 2 over the last week and we started to see some yellows finally (although still some reds, especially yesterday). Curious what dose would be appropriate as his PMPS just now was 200. Thanks!
 
Lovely yellow preshots! Wonder how low he is dropping mid cycle - looks like not enough to bounce. I think 2 units looks good for the mid yellows. Since it's overnight and he is right at 200, maybe reduce a little. What do you think about pulling up 2 units and letting out a couple drops?
 
That's what we were thinking! Just under 2 units. Thank you! A bit concerned with his full day of red numbers yesterday but he could have just eaten a bit right before we got that midday number. My husband will be home tomorrow and hopefully able to get some mid cycle numbers which will hopefully give us some good information.
 
So AMPS was 397, gave him 2.25 (was able to get two midday readings 198 and then 437), and now his PMPS is 414... thinking that the second midday reading might have been affected by some eating. We took all food away 2.5 hours before this PMPS. So much for nice yellow numbers :(
 
Likely the higher numbers were a bounce. When their body perceives a lower number than it is used to, it releases extra glucose, causing the levels to "bounce" higher than "normal". This is a very common phenomena. Just keep gathering the data. Things will become clearer, the more info you get. Meanwhile, those were nice numbers !
 
Some very confusing numbers today and yesterday! Just when i thought we were finally getting some consistency with some yellows/pinks... any advice or suggestions? :arghh:
 
SilverSap said:
Some very confusing numbers today and yesterday! Just when i thought we were finally getting some consistency with some yellows/pinks... any advice or suggestions? :arghh:
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Looks like more bouncing going on. You mentioned in your first post above that you couldn't get Blackberry on a regular BG pattern with Lantus and switched to ProZinc in September. There are some decent numbers showing up and as Sue said above, you need to keep gathering data. It takes time and patience ...
 
I think today looks like a normal bounce - nice lower numbers in the middle. I think he is generally bouncing, and we say that cats bounce till they stop. There isn't much to do except wait. I like your doses. I would just keep doing what you are doing. The good news is that he is getting into nice numbers midcycle.
 
Thanks so much for replying! It is helpful to get feedback because it just feels so defeating each time I think we're getting somewhere, into a pattern, and then a huge jump. Today's AMPS was 232 so we lowered the dose a bit. As you can see, the readings we've gotten at +2 and +4 are increasing. Not sure if that has to do with him eating, but I would assume that the insulin dose would combat that climb. Will continue to get more readings today and keep gathering data like you suggested!
 
Hard to tell. This cycle could be a bounce from the blues yesterday. Or maybe the dose for 232 needs to be a little higher. Regardless, some nice numbers lately. Keep gathering that data!
 
So today we had an AMPS of 225 and because yesterday was similar and his midday numbers we high, we thought that perhaps he needed a higher dose. Well his midday numbers today are VERY low. Behaviorally he was fine, did not even know anything was wrong until we took the reading. (he has had low numbers before, when he was first diagnosed and on Lantus, and it was the same thing, no behavioral signs at all) We gave him food and syrup and the BG is slowly on its way up. Could he be bouncing from previous cycles? I am so confused!
 
SilverSap said:
So today we had an AMPS of 225 and because yesterday was similar and his midday numbers we high, we thought that perhaps he needed a higher dose. Well his midday numbers today are VERY low. Behaviorally he was fine, did not even know anything was wrong until we took the reading. (he has had low numbers before, when he was first diagnosed and on Lantus, and it was the same thing, no behavioral signs at all) We gave him food and syrup and the BG is slowly on its way up. Could he be bouncing from previous cycles? I am so confused!
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Might be from shooting 2.25 u on an AMPS of of 225 because you haven't done as high a dose on as low an AMPS, at least recently. Could also be a delayed reaction to the 2.5 u you gave last night. It's hard to know.
 
Not sure. Could be a delayed bounce from 10/9. But I think it's more likely that the 2.25 was too much insulin. I'd reduce the dose for those yellow amps numbers.
 
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